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how do you handle this?

I know this is a basic question, but what do you do if patient's bladder is very distended and full, but cant insert foley in male patient?


Specializes in ER.

Two questions:

1. Why can the patient not urinate? (assuming this is the case since the bladder is distended)

2. Why could you not straight cath?

Need more info to answer the question:)



Specializes in ER/AMS/OPD/UC.

What do you mean can't insert a foley?:nono:

I know this is a basic question, but what do you do if patient's bladder is very distended and full, but cant insert foley in male patient?

Do you mean something is physically stopping the foley from advancing? Or you don't have an order to insert foley??


Specializes in ER< OR < Med Surg.

can't answer your question hon, be more specific, or need a bit more of information about the problem...

Patient have a prostate problem, and he has a foley catheter. His foley is not draining any urine and bladder is distended, and patient is complaining he have to urinate. I tried to flush his foley but still urine is not draining. Three different nurses tried to insert a new foley, but there must be some kind of blockage, and could not do it. So do you think I'll be able to drain his urine by straight cathering him? If I cant insert foley, i dont know if I'll be able to insert straight catheter. What do you do? Can his bladder rupture?

How about requesting a urology consult. Or if he already has one, call him/her. I have seen cases where only the urologist can attempt to insert the foley.

Jennifer, RN

Specializes in ER, telemetry.

In the ER I work at, the ER doc would call a urologist in and the urologist would try to insert a foley with all their special tools. If unable to get a foley cath in, they would then insert a suprapubic cathether. Yes, a bladder can rupture, eventually. And a distended bladder is very, very uncomfortable for the pt.


Specializes in ER, PACU, OR.

call the urology group and get an acute urinary retention tray down there............

ever see it done?


Not me looks painful as He**

Suprapubic . . . .

A straight cath is no different than a cath intended to stay in . . you still have to get past the blockage and with an enlarged prostate, you may not be able to cath.

Definitely a case for a urologist or the ER doc or pt's doc to attempt.


ktwlpn, LPN, RN

Specializes in Med Surg, Homecare, Hospice.

one of our local urologists always has us attempt to pass a straight cath before we send the resident out to the ed in the middle of the night.Our foley caths are soft -the straight caths in our kits are firmer and sometimes you need that to get past a prostate (under doc's orders,of course) It sounds like your guy needs to be seen by a uro asap.

EDValerieRN, ASN, RN

Specializes in ER, Peds, Charge RN.

Try a coude tip, and it also helps to get a bigger french catheter. The little ones will not hold as well as the bigger french, especially if the patient has had a catheter for a while. Use lido instead of KY, the guy is going to hurt.

I wonder if the cath had slipped out of the bladder and just needed advanced? Sometimes those urethras stretch out when they've accomodated a cath for so long. I don't think I would have removed the first cath until urology came to look at it, but then again, some hospitals don't have the luxury of urology 24/7, I'm a lucky one.

What ended up happening?


Specializes in Geriatrics and Quality Improvement,.

I've seen suction caths passed, in an emergency, you need to get it empty....get the smalllest FR. available....heck, Id try to pass anything for my guys..

and yes, coude is most effective for many reasons...

I know this is a basic question, but what do you do if patient's bladder is very distended and full, but cant insert foley in male patient?

Does your facility have a bladder scanner? If so, do a bladder scan. If not, you neeed to straight cath him and find out how much urine is in his bladder. Why can't you insert a foley. Is his prostate in your way? Some times you have to push fairly hard to get past the prostate. Anyway, if the man can't urinate, you will have to call the DR and document that in the chart. He will most likely tell you to put in a catheter.


canoehead, BSN, RN

Specializes in ER.

A Coude or a firmer catheter in a small size may work. We also have lidocaine jelly that you can "inject" into the urethra and use as a lubricant and numbing lotion. I've had lots of success with that when I can't get past an obstruction- the patient relaxes and there is a little more room.


Specializes in disability.

Hmmmmmmmmmm not being able to advance the catheter would really tick me off but some times getting the experts is the best answer even if it does cause initial embrassment. Hey it can always be justified as pt comfort and safety!

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